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In Type 1 diabetes (also known as juvenile diabetes), the pancreatic cells that produce insulin are destroyed so that insulin can no longer be synthesized or secreted into the blood

These substances activate immune responses, stimulate the production of inflammatory cytokines, disrupt glucose and lipid metabolism, exacerbate endothelial damage and atherosclerosis, thereby accelerating CHD progression 136

Efficacy and safety of the dipeptidyl peptidase-4 inhibitor sitagliptin added to ongoing pioglitazone therapy in patients with type 2 diabetes: a 24-week, multicenter, randomized, double-blind, placebo-controlled parallel-group study

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CMS pays for and processes these drugs separately, on its own